Erectile Dysfunction (ED) Information
Test & Diagnosis
The following conditions can cause erectile dysfunction
Diabetes. High levels of blood sugar associated with diabetes can damage small blood vessels and nerves throughout the body, including those in and around the penis. Diabetes can interfere with the nerve impulses and the blood flow necessary to produce an erection. About 60 percent of men with diabetes experience erectile dysfunction.
Heart disease. Atherosclerosis, which cases hardening and narrowing of the arteries, increases with age. Over time it can reduce blood flow to the penis and lead to erectile dysfunction. It accounts for most cases in men over 60 years of age.
Leaking veins. When veins in the penis are not compressed during an erection, a vein can leak, leading to erectile dysfunction. A leak can be the result of injury, disease, or damage to the veins of the penis.
Neurological injuries or disorders. Spinal cord and brain injuries, including paraplegia and stroke, can cause erectile dysfunction when they interrupt the transfer of nerve impulses from the brain to the penis. Other nerve disorders, such as multiple sclerosis, Parkinson's disease, and Alzheimer's disease, may also result in erectile dysfunction.
Drugs. More than 200 prescription medications may directly cause or contribute to erectile dysfunction. Among these are drugs for high blood pressure, antidepressants, tranquilizers, sedatives, and a number of over-the-counter medications. Long-term, excessive consumption of alcohol and use of illegal drugs such as heroin and cocaine also can cause erectile dysfunction.
Hormonal imbalances. Hormonal disorders account for fewer than 5 percent of cases of erectile dysfunction. Testosterone deficiency, which is rare, can result in the loss of libido (sexual desire). An excess of the hormone prolactin, produced by tumors in the pituitary gland, reduces levels of testosterone. Kidney and liver disease also may lead to hormonal imbalances that contribute to erectile dysfunction.
Peyronie's disease. This is a relatively rare, inflammatory condition that causes scarring of the erectile tissue in the penis. The scarring produces a curvature of the penis that can interfere with sexual function. In addition, it may cause erections to be painful.
Pelvic surgery. With surgery of the colon, prostate, or bladder, the nerves that control the flow of blood into and out of the penis may be cut or removed. These nerves can be permanently damaged in men who have undergone radiation therapy for prostate or bladder cancer. Although these nerves do not control sensation in the penis and, therefore, are not responsible for orgasms, they influence the firmness of the penis during erection.
Some surgeons may try to spare nerve function during these procedures, with the hope that any sexual function problem will be temporary. Usually it takes six to 18 months for erections to return. Partial erections may return sooner. If they do, it could be a sign that complete erectile function will eventually return.
Pelvic injury. A minor injury to the pelvic area, including a fall or blow to the hip while playing sports, or a very long bike ride, can sometimes numb the nerves around the penis and block their normal functioning. A day of rest is usually enough time for the nerves to recuperate.
Psychological causes. Even though most cases of erectile dysfunction are the result of physical factors, psychological factors should not be overlooked. The most common psychological cause of erectile dysfunction is performance anxiety, a man's fear that he will not be able to perform sexually. Anxiety may lead to an initial failure, which increases the anxiety, resulting in a cycle that leads to future failures to achieve an erection.
Stress, tension, depression, worry, guilt, and anger can also inhibit sexual performance. These psychological factors may occur secondary to and possibly as a result of the physical causes. They may magnify the impact of erectile dysfunction resulting from physical causes.
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